Joint aspiration
Unexplained joint swelling may require aspiration to aid diagnosis. The
aspiration itself may be of therapeutic value lowering the pressure and
relieving pain. It is often coupled with intra-articular washout or
instillation of steroid or antibiotic as appropriate. Examination of the
synovial fluid may be of diagnostic value (see Table 8.2).
Crystal arthropathies such as gout and pseudogout can be differentiated
on examination of the crystals with polarised light microscopy. The crystals of
gout are negatively birefringent, whereas the crystals of pseudogout are
positively birefringent.
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